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Thoracic and lumbar laminoplasty using a translaminar screw: morphometric study and technique
Sung Bae Park1, Tae-Ahn Jahng, Chi Heon Kim
1Department of Neurosurgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Korea.
Journal of Neurosurgery. Spine
|June 30, 2009
Summary
This study introduces a new laminoplasty technique using translaminar screws in the thoracic and lumbar spine. The novel approach proved feasible in a small patient group, with no immediate complications observed.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Orthopedic Surgery
Background:
- Laminoplasty is a surgical procedure to enlarge the spinal canal.
- Translaminar screws offer a potential fixation method in spinal surgery.
Purpose of the Study:
- To describe and evaluate a novel laminoplasty technique utilizing translaminar screws in the thoracic and lumbar spine.
- To assess the feasibility and initial safety of this technique.
Main Methods:
- A morphometric study using 3D CT scans and simulation software was conducted on 20 control individuals to determine safe screw trajectories.
- Translaminar screw fixation was attempted in 5 patients with intradural lesions (schwannomas, cavernoma, arachnoid cyst) following en bloc laminectomy.
- Screw dimensions and placement success rates were recorded, along with any intraoperative or postoperative complications.
Main Results:
- Morphometric analysis indicated safe screw trajectories of 25-30 mm length and 8-11 mm diameter in the thoracic spine, and 26-34 mm length and 6-7 mm diameter in the lumbosacral spine.
- In 5 patients, 14 out of 16 translaminar screws were successfully placed after en bloc laminoplasty.
- No complications related to the translaminar screws were observed during a mean follow-up of 14.5 months; solid osseous fusion was noted in 2 patients.
Conclusions:
- The described laminoplasty technique with translaminar screw fixation is feasible in the thoracic and lumbar regions.
- Further research is required to investigate the biomechanical properties and long-term outcomes of this surgical method in a larger patient cohort.
